Hughes R.-A.-C.
Cochrane Neuromuscular Disease Review Group, Guy's, King's and St Thomas' School of Medicine, Guy's Hospital, London SE1 1UL, UK.
Rev Neurol (Paris). 2002 Dec;158(123):32-36.
Chronic inflammatory demyelinating polyradiculoneuropathies include chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy (MMN) and paraprotein-associated demyelinating neuropathy. This review summarises the evidence from randomised controlled trials (RCTs) for the treatment of these conditions. It leads to the conclusions that: 1) steroids are beneficial in CIDP but not MMN and their efficacy in paraproteinaemic demyelinating neuropathy (PDN) is uncertain; 2) intravenous immunoglobulin (IVIg) produces short-term benefit in CIDP, MMN and IgM PDN. Its effect in IgG or IgA PDN has not been tested in RCTs; 3) plasma exchange (PE) also produces short-term benefit in CIDP and IgG or IgA PDN but probably not in MMN; 4) there is almost no information from RCTs concerning the possible benefits of immunosuppressive agents; and 5) volunteers are needed to write Cochrane systematic reviews of IVIg for MMN and of interventions for PDN associated with IgG and IgA.
慢性炎性脱髓鞘性多发性神经根神经病包括慢性炎性脱髓鞘性多发性神经根神经病(CIDP)、多灶性运动神经病(MMN)以及副蛋白相关的脱髓鞘性神经病。本综述总结了随机对照试验(RCT)中关于这些疾病治疗的证据。得出以下结论:1)类固醇对CIDP有益,但对MMN无效,其在副蛋白血症性脱髓鞘性神经病(PDN)中的疗效尚不确定;2)静脉注射免疫球蛋白(IVIg)对CIDP、MMN和IgM PDN有短期益处。其在IgG或IgA PDN中的作用尚未在RCT中进行测试;3)血浆置换(PE)对CIDP和IgG或IgA PDN也有短期益处,但对MMN可能无效;4)RCT几乎没有关于免疫抑制剂可能益处的信息;5)需要志愿者撰写关于IVIg治疗MMN以及与IgG和IgA相关的PDN干预措施的Cochrane系统评价。